1. Field of the Invention
The present invention relates to an endoscope, and more particularly, an instrument for endoscopic therapy having a longitudinally-slotted probe connected to a guidance part to accommodate for example, an optical system, which is interposed within the guidance part in an axially movable fashion and which extends into the probe to permit viewing through the optical system to be directed toward the longitudinal slot of the probe.
2. Description of the Prior Art
Surgical or diagnostic procedures of the invasive types are usually, and justifiably, a choice of last resort for both the patient and his or her physician. One reason is that such procedures are traumatic to the patients and thus necessitate the administration of expensive anesthetics--local or, even, general. Another reason is that complications such as infections may ensue, thereby making post-operative care critically important.
Having mentioned some of the drawbacks of invasive procedures, one appreciates the value of surgical techniques known as minimally invasive procedures. These procedures recognize the fact that at times invasive surgical or diagnostic procedures are inevitable. However, the trauma or associated complications can be dramatically reduced if the number of incisions in the epidermis are kept to a minimum such, for example, as in a single-portal procedure which requires only a single incision, as opposed to a two-portal procedure, which requires an entry incision and an exit incision. Additionally, in this age of ever-increasing medical expenses, a procedure which is cost-efficient as a result of permitting surgery by a single physician as opposed to two or more physicians is highly desirable. To that end, an instrument which enables a single physician to perform a single-portal procedure is highly desirable.
WO 93/10 704 discloses an endoscopic instrument which is utilized in a two-portal procedure for the treatment of carpal tunnel syndrome, a peripheral neuropathy which is characterized by sensory loss, muscle weakness and atrophy, among other symptoms, in the hand and wrist area. The endoscopic instrument has a probe with a longitudinal slot which is introduced during the procedure into the entrance portal and brought out of the exit portal. To facilitate observation of the surgical area, a video arthroscope can be inserted into the distal end of the probe, which extends out of the entrance portal. The operative procedures are performed by introduction of suitable scalpel-type instruments from the proximal side of the probe. As a general rule, the surgical procedure utilizing this instrument requires that one operator performs the operation while a second operator is responsible for guiding the video arthroscope.
European Patent Application EP-A-0 552 980 discloses an instrument for use in the so-called single-portal procedure for treating carpal tunnel syndrome. This instrument is comprised of a hollow probe closed at the distal end and having a longitudinal recess therein which permits the introduction of a suitable surgical instrument, such as a scalpel. The proximal end of the probe allows the introduction of an optical system for observing the operation. The disadvantage of this device is that optimum work is possible only when two operators work together.
Reference to anatomical factors and requirements in the treatment of carpal tunnel syndrome is also made in U.S. Pat. No. 5,029,573, which describes another instrument for the two-portal procedure, as well as in U.S. Pat. No. 4,962,770 and U.S. Patent No. 4,963,147, both of which disclose instruments for the single-portal procedure. The operative method of surgery utilizing endoscopic devices is known to those skilled in the art and is described in European Patent Application EP-A-552 980 and thus need not be discussed here.
The instruments according to this prior art, are generally disadvantageous in that two operators are always needed to perform an operation. Furthermore, in the two-portal procedure, the need to make two incisions, thus placing additional traumatic stress on the patient, must be seen as disadvantageous. Similar problems result when instruments of this type are used, for example, in treating paralysis of the radial nerve and other neuropathological conditions.
Therefore, it is an object of the present invention to provide an endoscopic instrument for diagnosis and treatment that requires only one incision and can be operated simply and by a single operator. Furthermore, the instrument is to be equally operable by left-handed and right-handed persons. Another object of the invention is to provide an endoscopic instrument which is comparatively stable and can be easily disassembled to allow for optimum cleanliness and disinfection.